Ep. 30 | Madison Hill, DO, Family Medicine, SGMC Health

Transcript

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- Welcome to another episode of What Brings You in Today.

- I'm Erika Bennett.

- And I'm Taylor Fisher.

- And we just wanna thank everyone for tuning in. We always appreciate our fans and we hope that you will like and subscribe to our podcast and be sure to interact with the podcast as well. So leave us questions of things you would like to hear about.

- Yes, you can submit those questions at sgmc.org/podcast.

- Alright, well I'm here today with Madison Hill, DO, family medicine physician. So Dr. Hill, what brings you in today?

- I am here today to talk a little bit about family medicine and lifestyle medicine, so thanks for having me.

- Well it's a great to have you in here. You are actually, I'm just gonna self disclose that Dr. Hill is my primary care provider as well, so I can vouch that you're great at what you do. But we do wanna, I want more people to learn about family medicine and kind of explain a little bit about what drew you to family medicine, what it is for that average listener.

- Absolutely. So a little bit about me. I grew up in South Georgia, so on a farm just right outside of Moultrie. So southwest Georgia is home for me. I actually had a really fantastic family med physician growing up who actually was a female and a DO. And so she's kind of who started me along that path. And I knew that really early on, like in middle school and here we are.

- That's amazing because I don't feel like female physicians were prominent back

- Then. No. And she, she was one of the very first in, in the town. She practices still actually in Camilla. And so it's really cool now to get to, to see her and still be involved kind of in that process. And so it's kind of a full circle moment.

- That's really cool. Yeah. What made you decide to be a

- Physician? So I, I really think that it was just seeing what she got to do on a daily basis. So she let me shadow her really early on and so kind of fostered that love just of getting to walk through people's lives together. And so that's one of the things that, you know, you get in all aspects of medicine, but really with family medicine, you know, you get to, to see them throughout all portions of their lives. Especially if you still do OB and deliveries, you might deliver the baby. You get to see them grow up in your office when they're pediatric age and then if they are still, you know, in your same practice, you get to follow them through their life in adulthood. And so that's really cool, really unique thing that you get that maybe if you're a specialist you get to see them one or two visits but you don't get that that longitudinal relationship, which I, I really love.

- I think that's so cool. And I honestly, I'll have to say when I started working here, I didn't know the difference between, well really a lot of things, but family medicine and internal medicine and what all the differences between that. Can you explain a little bit about that?

- Sure. So I think a lot of people's question rely or kind of goes back to how do you like choose to see the specific patients that you see, right? And so in family medicine I get to see kind of any patient I want to see. And so especially for the pediatric portion, there are three ways that you can see pediatrics once you graduate medical school. One of those is through formal, formal training in a pediatrics residency. And so if you choose to do a pediatrics residency, you'll just see peds for the rest of your life and then you can choose to specialize if you want to or you can just do general pediatrics or hospitalist medicine. The second way you can see peds is through a joint internal medicine pediatrics program. So you get the adult training from the IM and then you also get the specific peds training. With that though, you wouldn't be doing women's health and you couldn't do ob. And so for me, I wanted all of the things and so with family medicine in, in your training, you're still getting to do women's health, you're still getting to do deliveries, you're still getting to see young kids as they're growing up and as they kind of age out and become adults in your practice. And then you can see adults of all ages too. So not having that limitation of only being able to see a certain subset of people is another thing that kind of drew me to family medicine. But just realize for all the physicians who see peds, it's not just one one specific like rigid pathway, right? There are multiples, but that's the, those are the three most common ways that you can see peds in your practice. And so for that, the other, you know, thing that's wonderful about family medicine is if you decide 10 years into your practice you don't wanna see pediatrics anymore, then, then you don't have to, you can make your practice really kind of what resonates with you and what your community needs and where you are kind of along your, your pathway in life.

- And speaking of like pathways, so there's also this another distinction that kind of differ differentiates physicians that a lot of people misunderstand or don't understand or maybe have never even noticed, but it's the credentials after your name. Yes. So whether you are an MD or a DO and you're a do so, explain the difference about that and kind of what that even means.

- Yeah, sure. So there are two different ways that you can become a physician in the US and it's just kind of two different types of medical schools. So we have allopathic medical school, which is going to give you an MD after your name, and then you have osteopathic medical school, which will give you a do after your name. And so your MD schools, that's your doctor of medicine, your DO schools is going to be your doctor of osteopathic medicine. So you are pretty much getting the, the same training those first couple of years in medical school. The difference in the do field is that you're also getting an additional at least 200 hours in something called OMM and that's osteopathic manipulative medicine. Okay. So let's say you're treating a patient like on a sideline in a football game like you could do with family medicine and they have a musculoskeletal injury. Some of the things that you learn in your DO training would allow you to, to fix that injury on the sideline. And so that's just additional training that you would get initially. DOS also were trained kind of to look at patients more in a holistic view, but that is becoming a little more mainstream. And so we're seeing that a lot in some of our MD schools too. And so that's not really as big of a distinction now because viewing patients as a whole person is, is something that just from an overall health standpoint in, in medicine in the US that that we're trying to change. Yeah. And so that used to be a distinction. Gotcha. But now, now not so much. But really the the manipulative medicine piece is, is our big difference there. Okay. And so for me, the reason I ended up choosing that is because I really enjoyed doing sports medicine when I first got out, I had a really great sports medicine physician when I was at University of Georgia. I was actually on the track team for a couple of years and they did a good bit of like sideline OMM. And so I got to see it used in practice and I was like, oh my goodness. Like I definitely wanna be able to do that.

- How fast can you run a mile?

- Well that was a very long time ago. What was your fastest mile? One kid later? I actually pole vaulted so I didn't run. Oh wow. That's even cooler. So Wow. That is, yeah.

- Well you just can't keep those fun facts from us like that. We need to know these things. That's, that is very cool. I just don't even know how you begin to practice pole vaulting though.

- You have to be a little bit crazy. Yeah. So I did gymnastics for a while growing up. Okay. And so when I joined the track team, actually in middle school, my coach was like, Hey, I think that you'll be a great fit for this. And then it just kind of went from there.

- Wow. That's cool.

- So yeah, just lots of experiences that led me where I'm today. Yeah. Yeah.

- That's very interesting. I, I'm a little thrown off by the pole vaulting part, so I know that we also, we recently learned that you were board certified in lifestyle medicine. Yeah.

- So can you talk about that? Sure. So lifestyle medicine is one of our newer medical specialties similar to, I know a lot of our physicians you've had on have been board certified in like obesity medicine. So it's along the, the same lines of the credentialing and and board certification for that. So I got board certified last year. And so what lifestyle medicine is, is basically using lifestyle modalities to treat chronic diseases. Our most common being cardiovascular disease, high blood pressure, diabetes. Right. And so lifestyle medicine focuses on six different pillars that we use to help treat these chronic diseases. One of those is our dietary patterns. I don't like saying diet because diet in my mind is restrictive. Right? So I, I don't like telling people they need to eat restrictive. Right. I want them to, to do something that allows them to eat just in a pattern that is, is lifelong for health and sustainable. And so in lifestyle medicine we're looking really more at like Mediterranean diet a, a plant-based diet, whole foods. Right? So close to how they come out of the ground as as you can get them for overall health. And then we target that towards specific diseases too because there's a little bit of nuance there in trying to target things for someone who has like cardiovascular disease versus someone who has diabetes. But there is overlap there. So that's the, the first pillar of lifestyle medicine. The second is going to be movement or exercise, right? And so 150 minutes of moderate intensity exercise is our target on a weekly basis. But how we do that is unique to each patient, right? You can't just say, oh, go exercise for 150 minutes. That that doesn't really do it. We really have to dig into, well are there any issues that the patient is having? Let's say they have osteoarthritis telling them to walk 150 minutes a week is just not going to work. So it's very specialized for that person. The third thing that lifestyle medicine focuses on is quality sleep. Okay. And that could be just addressing barriers to sleep if maybe the person has sleep apnea, multiple different things. But seven to nine hours is usually our target for healthy sleep. And that's going to really enrich just overall health and wellbeing. One of the fourth things that lifestyle medicine targets is stress management. And so techniques to try to address that, because we've seen in the research that stress levels can also affect just overall health, right? Yeah. Be it from chronic diseases to, to mental health as well. The fifth thing that lifestyle medicine targets is trying to decrease kind of behaviors that would be deleterious to health. So maybe excess drinking or smoking. Things that we should not be doing that we know are probably already bad for ourself, but either decreasing those or forming a plan together in like a physician patient relationship to, to quit. And then the last thing that lifestyle medicine focuses on is social connection. And I think that's a super important one because I think we can all, you know, remember back to when the pandemic started and that changed everything from a social connection standpoint. And we had lots of people who went through a really tough time from a mental health standpoint because that is really a pillar kind of, of overall wellness and health. And that was just taken from us. And so getting to focus on that is one of my favorite things about that because we're out of the pandemic now, right? And so we can start to, to build on that and enhance just people's overall health

- That, I mean, that's probably the most comprehensive breakdown of like yeah. An overall wellness, right? That, and like all those things you mentioned are definitely so important to everything. And it is, I feel like it's hard, especially as like a woman, I kind of think of that meme where it's like you're trying to, to do all the things exercise Yes. And take care of the kids and keep the house clean and all this stuff. And that's can be overwhelming. Yes. So I think certainly having, you're kind of like a, like a coach. Yes. Like a little like

- A, which I love that part.

- Yeah. Yeah. And I think anyone would appreciate having that because it is overwhelming for just the average person to be like, what do I need to do to get kind of my life more manageable where I feel good? Yes. Where I'm healthy. I mean, that's a struggle, especially for women, I feel like because we carry

- So much of a load. The one of the questions that I ask most patients when they come visit me, you know, outside of any specific questions they have during the visit is, how can I help you be healthier overall? And that kind of sets the tone to say, Hey, I'm not just concerned about like the numbers. I'm not just concerned about like the specific like diabetes. Like we are going not just to make your diabetes better, but like what does overall health mean for you? And so some patients are super receptive and they've thought about that before and some it's a new concept. Yeah. But I'm okay with that. But that's kind of where the conversation starts.

- Yep. What made you interested in getting that certification and that whole field?

- Yeah, so it's, I I always wanted to just do more, right? And so I think my question was how, how do I do some, how do I do this in a professional way about something that I'm like also personally passionate about? And so lifestyle medicine kind of met me in the middle, and so now I can give a little bit of that back to my patients. Yeah.

- I really like that. I think that's super cool.

- I do too. I, I'm just trying to think about if I've ever thought about what would make my life healthier

- Or not. Yeah. It it's hard too, right? Because it's a, a new way of thinking. Like sometimes we go to the doctor and we have this very rigid, like, I'm here for my diabetes follow up, and then like if I just get my diabetes under control, then like I'll be healthy. Yeah. Right? Yeah. Well, well yes, I would love for you to have like a good A1C and really well managed chronic diseases, but there are other things that lend themselves to you being healthier overall.

- Right. And it just is taking a different look at it from, it's not just about like a medicine that's gonna fix a, you know, a something that you're experiencing. You're getting to the root of what's causing potentially that. And then really addressing that from just lifestyle changes. I mean know hence the name, but

- Like I would love for my patients to like, I would love to not write a prescription. Yeah. Like that is one of my favorite things is to have you be on less medicine or no medicine if we can truly fix this from a lifestyle standpoint, because a lot of our chronic diseases are going to be rooted in some of our lifestyle choices. And so there are some medicines that we, we can't get away from. Right. Right. There are some things that we need to do, you know, for good clinical practice for our folks with cardiovascular disease and our folks with diabetes that, that they do need to take. Right. I I don't want to to, right, yeah. To make light of that. Right. You know, everything can't just be fixed by, you know, targeting like a specific lifestyle change, but it can have a huge impact.

- Well even when you mentioned like the food and nutrition aspect, you know, that's something that I think everyone probably or a lot of people struggle with just because of access to like healthy, nutritious food. And when you're busy tend to like, you know, we had a whole episode on nutrition and even just spoke about it, what it means in our last recording about nutrition in the patient in inpatient world because, and you're talking about the, I saw it was really good foods and stuff. I mean that's, it's just so interesting and just, but again, it's, it's overwhelming if you just try to like Google that on your own or kind of learn. So I do think it's important to have that professional advice.

- And I think it's asking, this is asking the patient to take a more active role in their health where I think sometimes we get used to just gonna the doctor and well just do whatever the doctor tells me to do because we do trust our doctors. But also if you have a doctor, which I do, who asks you questions like, you know, how do you feel about this and what path do you want to take? I think that makes a big difference when you take an active role because you have to advocate for your own health.

- Yes. And I think it's super important. So one of the things that you, you train in when you do your lifestyle medicine certification is something called motivational interviewing. And it's kind of different than what you learned traditionally in medical school to

- Say, I think Dr. Bloch has talked about

- This. Yes. She has a little bit. And so motivational interviewing is not, is not a directing style in me saying, well, I'm the doctor and you need to do this, this, and this. Motivational interviewing is finding out, first of all making sure that we have a good relationship so I can understand where you're coming from, but also figuring out what motivates you. So you will be more likely to stick to that healthy behavior because just me saying, well, I think you should exercise more. Sometimes that's not very helpful. Right. And so initially when we start that motivational interviewing process, what I hear is a lot of what we call sustained talk, meaning like, I don't have access to healthy food, I don't have time to exercise, things like that. And I'm used to that, right? Those are all things that patients perceive or patients perceive as barriers. But if you work together a few more visits, you can say, okay, well like actually I think I can do this and this is why, or actually like, I wanna be healthier like for my kids or for my grandkids. And so we're, we're really digging deep to find the, the reasons behind why we want to be healthier, why we're motivated to make those changes. And once you do that, that's almost like a little bit of therapy, right. You will be much more likely to, to do those things than if I just give you a list of things to do and tell you that it's necessary to do it so

- Well I agree. And I do have to say that the first time I had my appointment with you after I left, which this was the first time I'd got like a primary care physician after my first appointment I got in the car and like I cried

- In a good cry

- In a good way. Okay. I guess like I had just never had anybody like really ask me about my health and getting kind of, it did make me start thinking, but then I also felt like I had support. Like I didn't have to do it all on my own. Right. And I think as I know I tend to do that, like I'm like kind of a controlling person. I like to have control in my life. Let's not put, put that out in my, but, so it was kind of nice. I was like, oh wow, like I don't have to do this on my own. Like I can have a partner in this, a guide and that. And I just think that's, I mean it's just beneficial. I feel like for people to know that you don't have to be nervous about going to the doctor. You don't have to be scared, you don't have to put it off. You don't have to wait till something very bad happens to go make that appointment and to do that thing.

- I agree. Like, like I think you should, everybody should seek to have a primary care provider no matter, you know, what stage they, they are in life. I think it's really important. But I do know when we start talking about these things, sometimes it can feel, feel very overwhelming, right? To the, the all of those six pillars, right? They're not just accomplished over overnight. And so for my patients, like especially with dietary changes, that can be very daunting when I'm like, okay, you're gonna try this new pattern of eating. And so what I found most helpful is, you know, I will provide them with resources even like little sample like dietary plans for a week that would be based off maybe like a Mediterranean diet. And I'll say, I know this sounds overwhelming because I'm asking you to overhaul, like how you were thinking about eating and what, like meat is healthy to you. But I say, okay, we're gonna pick three breakfasts a week and that's where we're gonna start. So like people are most likely to fail those first couple of weeks when you tell them you are doing bad and you need to do something different. And then they dump everything in the trash can that they think is like not healthy and then they go out and buy all of these things and then they feel overwhelmed because it's just this step from eating really terribly to trying to eat really well. But like every meal you just, you can't do it. Right. Ever. That's not, that's not sustainable and that doesn't mean that you failed. Yeah. Like it just means you're a human. And so I say, okay, we're gonna pick Monday, Wednesday, Friday, and now we are going to research and we're going to find what is kind of what we have talked about that would fall within like a Mediterranean diet and we're gonna plan our Monday, Wednesday, Friday breakfast and so like that we can do. And then you find things that are good to you and also good for you. And then you do that and then you execute that. So not only are you not overwhelmed, but you also see progress, which I think is really important when you're trying to make these like truly sustainable changes. Yeah. So little itty bitty bites. Same thing with exercise, right? Like, so telling someone who currently does not exercise at all that you need to get 150 minutes a week like that is, that sounds terrible to them.

- Yeah. - Number one, they may not like to exercise. Right. Which I try to work on kind of with my patients, like what's the idea behind that? Right. I don't think exercise should be punishment. We just haven't found what you enjoy doing yet. And so if you're not currently moving, then just five minutes a day of just purposeful movement, we can do that. That's doable.

- What are some of the, we talked about diet and exercise, but what are the other biggest lifestyle factors you see that can impact someone's health long term?

- Yeah, so I'd say, you know, we talked about kind of like the six tenets of lifestyle medicine, but I'd say really what I see in a lot of my patients is like the, the social connection piece, right? And so as, as humans for overall health, we need social connection. And I have a lot of people who are still reeling, like I mentioned from the pandemic to just say, I, I don't know how to do this anymore. Right? We were so isolated for, for so many years and now we're trying to get back into this that I've seen a lot of like issues from a health standpoint, mental and you know, physical from them not being able to establish good social connections. And so that's a, a big one that I'm seeing right now. That's really important to have.

- Yeah. Wow. Yeah, I guess we don't think about how important that is, but I mean, it, it is in everyday life. You know, if you, you know, say you work from home like my husband used to, and then you don't go out after work. So basically you're never seeing any people. You just see like your spouse maybe if you are married and then that's it and you maybe try to see some friends on the weekends, but I really don't think that's enough social interaction to keep people, you know, healthy and motivated. And I could see where that would be a huge factor for sure.

- Well, love this conversation could go on all day about that. But we do have some other exciting news in the realm of family medicine. SGMC Health was just approved for a family medicine residency program. Yes. So we're excited that we're kind of getting that. And you're very in instrumental in that. You're the director of this program, correct? Yes. Okay. And so big deal for South Georgia and our area. Tell us a little bit about, you know, kind of where we're at, what to expect and kind of what just mainly what it means for the future of family medicine in the

- Area. Absolutely. So I'm super excited that we finally got approval. So we got approval for eight residents a year back in January. Our accrediting body is the A-C-G-M-E. And so they oversee kind of all, all residency programs in the US And so eight residents a year means when we have a full compliment. So three years worth of residents, that's 24 residents who are training here in southwest Georgia who would have the option to, to stay here and practice if they wanted to. And so, you know, family medicine right now in our community has a little bit more of an adult focus. There are not a lot of family medicine docs who are seeing pediatrics. And so one of our goals with the residency program is to really kind of revitalize that pediatric population in, in the family medicine realm. And so we, we definitely needed, I know we had looked at a community needs survey just a few years back in saying that, you know, for all of the kids who are here, we just don't have enough providers to see them. And so I don't want folks who are living in Valdosta to have to drive elsewhere for their care. Right. We need to be able to provide the care here. And so I'd say especially from a pediatrics piece, it will absolutely serve, you know, a community need.

- Yeah, well and women's health too.

- Yes. The, the women's health portion is going to be, you know, instrumental as well. And so we have, you know, wonderful OB care here, but there's always more that is needed that was identified in the needs survey as well. And so we talked about that a little bit earlier. You know, family med physicians can do deliveries. That's something they'll be, they'll be training on, they'll be training on doing prenatal care, they'll be training on doing wellness exams, pap smears, different types of birth control like IUDs and Nexplanons, things like that. And so just the access to care that people in southwest Georgia will have just by having this training program here

- Yep.

- Is is awesome. Yeah. And I'm just so excited for it. That's

- Amazing. Yeah. That's gonna be huge. I mean, we've already started to see the results from our internal medicine program where those p many of the physicians are choosing to stay here and I feel like once physicians get here or even just being able to have that training done here and not have to leave if you are from here and want to continue to practice here, it's just really cool, really cool thing to be a part of. So I'm glad that you're leading that charge. Yes. And we look forward to having some of those residents on our podcast whenever they get here.

- Absolutely. And timeline for us. So we'll start recruiting folks this fall. We'll start doing interviews most likely in September, usually through December and January. And then we would have our first class of residents here in July of 2026. It

- Will be here before you know that.

- Yes. We will blink and

- Then we'll

- Be

- July, 2026. That is so

- For sure. So

- That is so exciting. I, I know with our residency program they do hospital clinic and all these different things. So how will that work with these residents? What, what different areas are they gonna move around in? Yep.

- So it, so very similar, right? So my, my clinic right now, so I'm primary care Connell is going to turn into the residency continuity clinic. The idea behind continuity is that each specific resident has their own patient panel and gets to follow them throughout the three years in their, their residency. Right. And so that's good for the patients especially and you know, good for, for a resident learning standpoint. And so they'll be in that clinic a couple of times a week throughout their training and that increases as they increase in the, the year that they progress. They'll also be on hospital-based rotation. So they rotate in adult medicine, they rotate in pediatrics, they rotate in the ICU, they'll rotate in sports medicine, O-B-G-Y-N gynecology. They have a myriad of electives that they can do as well, like dermatology, pulmonology, things like that. And so they really have the option to get really full spectrum, like good, a very good depth and breadth of training here.

- That's so exciting. Yeah, I know. I'm excited. Me too. We're gonna have a hospital full of residents. I know. Just like, I love it. Just like

- Grey's Anatomy. Awesome. Yeah, I used to watch the show and I was like, wow, this is so cool. And I just didn't realize that we were gonna become that. I know it's such a short amount of time it's been, but the fact that physicians are choosing to come to our organization and to choosing us to help train them. And I say us, but I mean y'all because y'all are experts, they don't want us training them experts. But Gmcc health is, it is really cool and it really shaping the future of healthcare. So I know it's easy to get, you know, preoccupied with the day-to-day things, but really it's taking a step back and thinking about what you're doing from a generational aspect and for community health. I mean it's very impressive. It's very cool. So I just congratulate you.

- Thank you. Proud to

- Be a part of it and thank you for being here and serving. So with that, I think that's probably gonna wrap it up unless we haven't asked Dr. Hill the question.

- No we haven't. We've never had you on. So normally at the end we ask, and I know you're at a clinic, so I don't know how often you're here,

- But she's seen her. I've seen her come through the line.

- Yeah. How much you're here. But we do like to ask what your favorite meal is here. So we have the spice, you know, which is our cafe, and then we have our cafeteria. So what do you like to eat when you're here?

- Oh, so this is gonna go against everything that I just talked about. Right? Just forget everything. Yep. That's okay. But I kind of go by the 80 20 rule. Like let's eat kind of in a good dietary pattern 80% of the time. The other 20% of the time you get to like picks, you can still continue to be social. My favorite thing here is a cheeseburger. Mm. And sweet potato fries.

- Yes. Those are good. I've heard a lot about our cheeseburgers. Yes. Yep. Top notch. So

- Well. All right, well you can end my, everything in moderation.

- Yes. There you go. Yes.

- Doctor's orders. Yep.

- Well thank you so much for being here with us Of course today. Thank

- Y'all for having me. Yes, thank you.

- And thank you to everyone for listening and just remember to like, subscribe and submit your questions at sgmc.org/podcast.